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00043_Field_SRC.c15.C.7.txt
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1997-01-28
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Blood and Other Tests
• Diagnosis can be confirmed with specific hormonal assays measuring the levels of gastrin, glucagon, insulin,
VIP, somatostatin or other hormones .
• An elevated serum gastrin level (often 10 times normal) and an elevated stomach basal acid output for those
who have not had surgery should raise suspicions of the Zollinger-Ellison syndrome and its associated
gastrinoma.
• Measurement of plasma proinsulin may be helpful for diagnosing an insulinoma.
• Low serum potassium levels caused by secretory diarrhea may indicate a VIPoma. $ Elevated levels of serum
somatostatin and diabetes with severe malabsorption should suggest a somatostatin-producing tumor .
Imaging
• Chest x-ray.
• Abdominal CT and MRI scans.
• Ultrasonography. This may be performed with a probe on the skin (transcutaneous), within the lumen of the
stomach (endoscopic) or directly on the pancreas during surgery (intraoperative).
• Pancreatic arteriography can diagnose about 50 percent of cases, for some tumors—insulinoma, for example—
are rich in blood vessels and have a tumor "blush." This method is rarely used since the advent of ultrasound
and CT.